There’s the right escapist song for every situation.
Urological pathogens are infiltrating headlines, entertainment, and me.
Bill Clinton gets hospitalized with a bug that grew undetected in his urinary tract until it breached his excretory-circulatory barrier and put him in sepsis.
Another sick bladder stars in HBO’s Succession. When a corporate takeover attempt requires the tycoon’s negotiation skill, Logan Roy shows up deranged. Packing pills, braying about needing to piss. Obvious urological victim. The scriptwriters didn’t invent the mental loopiness angle—cognitive dysfunction may occur with UTI patients older than 65.
I’m that age, though compared to President Clinton and Logan Roy, I’m nobody. One of 150 million people each year, 2 percent of the world’s population, whose wizz swims with excess white blood cells that fight infection.
The microbe assaulting my innards has resisted pharmaceuticals for six weeks and caused burning, urgency, cramping, swelling, leaking, aching. I haven’t lost my mind, but for part of each day I hole up in bed like someone who has lost the will to live.
Five months ago this same bladder inducted me into the Intermittent Self-Catheterization community. Loss of bladder function isn’t a death sentence, but the workaround is littered with stumbling blocks. Difficulty acquiring medical devices. Bacterial contamination. Self-imposed home confinement, feeling like damaged goods. I’ve called the psych crisis hotline twice while awaiting in-short-supply mental care. My health record includes a new ongoing condition: Adjustment Disorder.
Despite adopting every known precaution and prophylaxis, I’ve contracted between two and seven infections, depending on whether relapses count as new infections or unchecked old ones. Escherichia coli, the super bacilli now bedeviling my bladder, are in it for the win. Their outer membrane and inner plasma defang many modern antibiotics. Their chromosomes efficiently clone themselves.
My urologist finally prescribed an antibiotic reserved for highly resistant infectious agents. I downed the first Ciprofloxacin capsule last night. Before too long, 20 fat hives arose on my shoulders and arms. Classic indication of medication allergy. I emailed my practitioner and booked this morning’s Tele-med session for advice.
The screen flickers. “Hi, so, I replied to your email,” my awkward doctor greets me. Translation: You’re wasting my time with this redundant appointment.
“You said stop Ciprofloxacin.” Pause. “I’ve taken three other antibiotics already, with no benefit!” The doctor should have reviewed my chart before meeting me. In my nine years under her care, she’s always been harried by the managed-cost system. “The lab test measured 100,000+ E Coli bacteria in my urine,” I say. “I’m scared of escalation to my kidneys.”
“I see what you mean.”
Being heard—this lights me up.
“But,” the doctor adds, dousing that hope flare, “you can’t continue taking a drug you’re allergic to.”
“Then what? Leave this disease uncured?”
Audible keyboarding: tunk-tunk-tunk. “Take another course of Nitrofurantoin,” she suggests, reading her screen.
“Cipro was ordered because that stuff didn’t work!”
Her face burns with impatience to move to the next queued sickie. My shades-of-gray quandary frustrates her slap-dash, black-white problem-solving approach to doctoring.
“Many things give me hives,” I throw out. “Band-Aids, mango, heat.”
“Oh! If you’re saying the hives aren’t from Cipro, it might be okay to continue it.”
A sound bite absolving her if dispensed medicine endangers me is not the dotted line I’m signing on. “What I’m saying is that despite Black Box Warnings on it, Cipro is a calculated risk I’m willing to take.” Before she can protest, I add, “If my throat were to swell, I have Benadryl and an EpiPen.”
Dr. W flings up her arms in chagrin and bucks her body back as if insuring distance from patient recklessness. “Talking about needing an EpiPen,” she cries, “is reason enough to discontinue this drug!”
I plant my feet, silent, while she tames her outburst.
“You’re leaving for a remote location,” she says calmly. “Without healthcare access—another argument for avoiding risk.”
“Not super remote. Forty minutes from San Rafael.” I know better but feel coy. Last July, after iodine dye for a scan triggered hives that landed me in urgent care, I asked to be discharged with an EpiPen prescription. “A jab buys you 20 minutes,” the ER doc said. “The average time it takes to reach a hospital in an emergency drug reaction.”
I’d always assumed one epinephrine injection halted anaphylaxis without further dosing.
Between us, the husband and I own five EpiPens. His for bee venom and shellfish. Medicines, injectable dye, and latex are my allergens.
My blank-faced GP has no solution. I say, “I’ll think about what to do.”
“I advise discontinuing Cipro,” she says. “Out of an abundance of caution. If you have further trouble, call the med center.” She logs off. And off I’m to go, still infected.
The abdominal scan that put me in the ER six months ago… that was the last day I possessed what I thought was a working bladder. Last regular day of my life. The next day I learned of my distended bladder, soft musculature irretrievably marred. The day after that I couldn’t pee a drop and made a beeline to the urology department. Life as I’d known it over.
“Once we’re rolling,” I tell the husband, “I’ll take my second Cipro.”
“You’re not afraid?”
“Scared shitless. But what option is there?”
En route we stop at San Rafael’s one special occasion restaurant open at midday. The husband crosses the street to collect the dinner for commemorating this audition for regaining my life. I stay behind to assess the response to the second Cipro pill being metabolized in my gut. My sweater is hiked to my bra when the husband quickly returns. No takeout bag trailing feast smells. “Food not ready?” I murmur, feeling a bump on my shoulder. Hive.One by one, beasts step from the undergrowth beside the road, our headlights snaring them in high relief.
“They’re closed.” He restarts the car. “Door’s locked. Note posted. Staff on vacation this week.”
“Not according to their website!” My fingertips verify three budding hives, probably fomented by the meal snafu. “Our order was processed. I paid $83!”
“I left an irate voicemail.”
We drive off. On the fly I track down a nearby takeout barbecue joint to ensure we don’t go hungry later. The remainder of the ride, the car smells of pork fat and vinegar.
Chicken Ranch Beach at sunset lavishes us with a sky awash in pastels. Mirrored cloud images shimmer in the striated bay beneath. Shore birds wing by on twilight sorties. When the sun’s crimson brushes the horizon, we carry ourselves back to the house and from the deck watch the first stars peek out. So far so good.
Come dinner hour, though, we contend with takeout grub whose tenures in the car and fridge have done it no favors. Coleslaw from a tiny plastic tub, more gray than green, bleeds pickling liquid into noncelebratory white bread slices sopped in congealed red sauce. Out of the microwave, stringy pulled pork needs to be pried apart with fork tines. I bring these oleaginous victuals to the table. A far cry from the elevated Italian dishes I ordered for this evening’s cheering-up.
While the husband plates his portions, I taste my wine and glance at this great room’s picture windows, wood stove, objects d’art. The lights are lowered for ambience.
The husband sits.
“Bon appétit,” I say in French. “Food looks like merde.”
He chews a forkful of pork. “Not bad.”
My consort is often amenable to making do, while I, beholding our fare, lament how upgraded this landmark moment would be with orata sea-bream, lamb shank, and insalatas. Had the restaurant been open as advertised.
Of course no swanky meal can eradicate infection or quell anxiety about my state of health. The less severe midday hive outbreak was a positive sign, yet my earlier bravado has waned. I question the wisdom of tonight’s 11 p.m. antibiotic dose. A pronounced drug reaction could end more than just the trip.
“To being here.” The husband clinks his bottle of nonalcoholic beer to my wine glass.
“Gratefully!”
We make eye contact and drink. By some accounts, alcohol irritates the bladder, but not mine. I taste the ropy, over-salted pork. The window-lined room feels wintry all of a sudden. We’ll want a wood fire after the meal.
I put my fork down. “Here’s an idea you’ll probably veto.”
Venturing into the cold night is not as irksome as you might assume. Every day of every week I stay up until midnight to siphon my bladder before bed and avoid performing the procedure in the dead of night. At home, television keeps me awake, but here we botched downloading the app to watch stations. Just as well. By the fireside, we’d read a Yiyun Li story aloud. At 10:40 we donned jackets and scarves.
Steering to the San Rafael Emergency Room isn’t only prudence. It’s a prison escape, another break from home-boundedness. I took Cipro # 3 as we circuited the near side of Nicasio Dam a few minutes ago. The water lay flat and silver, more stunning by night than ever by day. Reactions to medication being unpredictable, two EpiPens lie in my lap. Benadryl pills jiggle in my pocket when I shift in my seat.
Lucas Valley Road spindles between the French Ranch and Indian Tree wild land preserves. We brought music CDs for the ride, but the adhesion and release of the tire rubber on asphalt shushes us. Being hemmed in by thick woods makes our transport feel like a native tale, magic lurking around each bend.
We reach the hospital after my stomach acid breaks down the antibiotic. The high-lumen red EMERGENCY sign dominates the embankment above our street parking spot. Lumpy jacket buttoned over sweatpants, I have no intention of leaving the car. Only if triggered histamines choke off my breath.
“Hang a while?” I say. “Dire effects happen within 20 minutes.”
“Anything so far?”
I reach under my sweater for another fingertip body check. “Big hive at my armpit.” The sensation of activated mast cells occurs again, plumping of skin and oncoming itch. “Another’s forming below my shoulder.” I complete the search. “That’s it.”
“Two?”
“Yep. Down from four last time—moving in the right direction.”
“Want some music?”
I glance at three CD cases in the center console. “The Saints?”
The band’s Best of album cues up. The jazzy horn intro of cut one, “Swing for the Crime,” quells my anxiety pronto. This old outfit were punk before punk was a thing. The riffs, beats, snarls, turns of phrase, and melody changeups still can catch a listener off-guard in the best ways.
Our chins bop to the tune. Between tracks, the husband throws back some peanuts. The next song laments being “stranded on my own.” Two cars drive by on Montecillo Road. We are out of the wilderness, hospital ablaze, not stranded.
“This isn’t annoying, as evenings go,” I say, snapping a cell phone picture of the EMERGENCY sign.
“Agreed.”
“Know Your Product” starts. The intro’s blare is a clarion call. I turn up the volume and dance in my seat. The husband drops restraint and waves his arms. There’s the right escapist song for every situation.
My hips bounce as a police car patrols past.
The lyrics mention purchases that supposedly give your life a lift—smokes, a peachy juice. Because we all need something. Ciprofloxacin’s my “product.” It better work without repercussions.
At the song’s end, the husband buttons off the CD and laughs. “How suspicious did we look to that cop? Gyrating like we’re high.”
The car clock shows 11:39. “He barely noticed over-the-hill caucasians in a Prius,” I say. “Despite my broke-ass bladder, we look regular. Like people waiting for someone in the ER.”
“I guess. Ready to leave, Mrs. Normal?”
Ha. I never feel normal anymore. My body has crossed to the abnormal side.
“Soon.” I punch the back button on the CD player. Whap up the volume for a re-airing of “Know Your Product.” The song is more dance feverish the second time through.
The cop cruises by on the other side of the street. Making his rounds, knowing trouble when he sees it. Crazy old white people rocking out in a hybrid? Nothing to see here. Even with our microbiomes hosting 39 trillion critters each, we’re invisible.
And talk about invisibility, the female urethra for all practical purposes borders on unseeable. Minuscule, inobtrusive, sheathed, hidden, indisposed to handling or the human gaze. Under the best circumstance, a woman must hoist labia with fingers and tilt her pelvis to bring the orifice into focus for catheter insertion.The rhythm of each day is broken into pieces. Tomales Park Indian Nature Trail. Bathroom at house. Bovine Bakery. House bathroom. Side Street Kitchen. Bathroom. And so forth.
In the context of infection, the organs “down there” distort and chafe, complicating self-care. Between each of our excursions, I’m forced to dash back to the house, since public bathrooms, especially trail outhouses, offer bad lighting and worse hygiene. The rhythm of each day is broken into pieces. Tomales Park Indian Nature Trail. Bathroom at house. Bovine Bakery. House bathroom. Side Street Kitchen. Bathroom. And so forth.
Following Night Two’s toasty fire, we set out through the dark forest, duplicating last night’s expedition. Same parking spot outside the ER. “Know Your Product” replays as the night’s theme song. I can’t get enough of it. The cop car creeps by again. It’s like today’s date is Groundhog Day, not January 5.
But no more hives appear. That’s the difference a day makes. I now know Cipro is safe to take.
Bloomless winter bog lupine grows along the way, with fescue and coastal buckwheat interspersed. At my devitalized tempo, we’ll barely be able to traverse the rugged chapparal and appreciate brief beach time before retracing our route. Every step I take represents a détente between safety and vigor. The footing is especially jerky along the sloping sand dune shortcut. Oncoming hikers on the narrow creek-side path force me to take evasive action that wrests multiple tendons.
The rock outcroppings rising on the sandy saddle are known to contain plankton skeletons from seven million years ago. At the trail’s terminus an archipelago of creek tendrils stretches to the sea. My neck and wrists get whipped by wind-blasted sand grains: quartz, feldspar, magnetite.
The blurry stone bluff up the beach dates back hundreds of million years, to between the Paleozoic and Cretaceous eras. At Point Reyes, known to the peninsula’s ancestral peoples as Tamál-Húye, one has to marvel at our abiding firmament. Up the beach lie noteworthy twisted granitics, but a deficient bladder will have its way, and we take our leave without witnessing them.
“Nice spot,” the husband comments.
“The little we saw.” Another set of beach seekers comes near. Even vaccinated and outdoors in cleansing wind, there’s that lingering fear of strangers bearing COVID. “I’m bobbing and sidestepping more than someone with tendons awash in Cipro should be doing,” I say and demonstrate a quick feint and leap.
“You’re juking,” the husband says. “Stop.”
“I’m not joking.”
“J-U-K-E. Football term. The quarterback or receiver runs with the ball and changes direction rapidly to not get tackled.”
“No rapid darting on Cipro.”
“Barry Sanders of the Detroit Lions was legendary for juking. Look him up.”
“Oh.” I don’t intend to. My interest in football is less than zero.
“I bet there’s a YouTube of his best rushes online.”
“Juking highlights of Barry Sanders?” I riff and shrug. Still no rooting interest. “Did you know Richard Nixon funded the creation of Point Reyes National Seashore? Quite the environmentalist, that guy.”
Over a pot of herbal tea at the house, I mention our pilgrimages to the San Rafael hospital.
The son shakes his head and laughs. “Probably wasn’t necessary.”
“My PCP seemed freaked about my allergic response!” I wash our mugs at the sink. “We won’t go tonight, though.”
“It was fun,” the husband says.
“Should we visit Chicken Ranch Beach before ordering pizza?” I dry my hands and on a lark reach for a bubble-pack, brought from home, sitting untouched in a rustic basket with our baggies of vitamins. “Want a gummy? We’re on vacation!”
The husband and I haven’t mellowed out with cannabis with either of our offspring before. Not that we’ll get crazy high and delve into conversations of unimaginable weirdness from such small doses. I cut the gummies in half.
“We can take another half if we want,” I say, knowing we won’t.
We descend the hill to the little local beach. Much of my life, a likeness of me could have illustrated a dictionary definition of letting the great be the enemy of the good. I’ve always been an optimizer when traveling, but that impulse has by necessity been curbed. Still, if I let it, Tomales Bay feels extraordinary enough. The entourage effect of cocktailed THC and terpenes doesn’t hurt.
Back on Sir Francis Drake Boulevard, the son says, “Isn’t that boat wreck near here?”
“What boat wreck?”
“I just read about it,” he says, making my chest pang with love for how like me he is, researching quirky spots of interest to geolocate. “It’s behind the Inverness Store up there.” He’s even bested me on this unknown attraction.
The husband dawdles to examine something on the road, while the son and I join a small throng of photographers and bayside merrymakers paying homage to the beached “Point Reyes” fishing vessel, a hundred-year-old rust bucket beached at a picturesque tilt in dusky light. A snapshot happenstance. A salvaging.
The owner of the San Rafael Italian restaurant calls the husband’s mobile phone when we’re back indoors. On speaker, he promises our refund will be processed when he reopens. “I arranged for our online ordering system to be deactivated during the vacation,” he explains, “but for some reason it never happened. Whatever messed up, I’ll look into.”I’ve read social media posts in a support group from women who brazenly catheterize at trails and campsites and scoff at contamination risk.
The husband stammers into the phone about our disappointment.
“I understand, but you aren’t the only ones who didn’t get their orders. My other customers plan to come by another time for takeout. We’d love you to. The pandemic’s been hard on us.”
I nod and sigh. We’re not Marin County regulars who can casually pop by his business. I barely leave my house, and San Rafael is far off my radar.
“Got it,” the husband says. Despite him knowing what that dinner meant to me symbolically, saying so looks to be a struggle. “We just…” he exhales, “don’t feel whole from this experience.”
Not “feeling whole” usually refers to a financial transaction. This isn’t about money. Or wrangling free grub. The husband looks lost. He’s more high, I realize, than I am.
“Why don’t you come by next week,” the guy on the line says, “and we’ll comp you one of our Italian desserts. You like tiramisu?”
I mime the cut gesture at my neck. Shlepping to San Rafael for a wedge of tiramisu—no.
“That’s not… feasible,” the husband mutters.
If only I could share with the restaurateur my fear of quiescent bacterial reservoirs in my bladder, immune to remedies. This man has no idea that I orchestrated this symbolic trip to kick off with delicacies made by his kitchen. The conversation in question isn’t about lamb shank. It’s about trying to feel whole in a deeper sense, about another little heartbreak heaped on top of a mountain of spirit-crushing heartbreaks.
The call ends, my piece not spoken. The husband, normally my champion and a dogged advocate for restitution when our rights as customers are violated, seems to have been pacified by a trifle of marijuana. Or maybe he realizes before I do that the wise aftermath is to let this beef go.
The accommodating landlady of our Airbnb has authorized a late checkout, which, she knows from back and forth emails, allows another Point Reyes junket and bathroom break before heading home. Mid-morning, we three drive to the marquee Estero trailhead and launch out along the open pastoral grassland.
“Taking it slow, because of the Cipro,” I remind the son, apologetically. I needn’t have said a thing. Unlike his preternaturally speedy mom, his trekking style is leisurely, intent on drinking in sights. Good son-to-parent lesson.
We stop to examine heavily rutted mud along a marshy stretch.
“Looks like cattle trampled through,” the husband says.
Our clan forges on. A familiar stand of pines rises ahead. The old Christmas Reyes Tree Farm, one of several such operations that dotted this area’s landscapes mid-century. I don’t momsplain the history aloud. Quiet is more to my liking.
In a highlight reel I’ll watch at home, stadium crowds roar approval for Barry Sanders’ superhuman juking agility. I’d never heard of this wonder of wonders before Inverness. Until recently, I’d never heard of cystoscopy or periplasmic space or Chicken Ranch Beach, either.
I’ll Google The Saints in the next couple of months, prepping to write something about taking my debility on the road. Chris Bailey, the singer, died, I find out in shock, at age 65, two days previous. What a gift life is, though I foolishly forget.
There’s a brilliance from the intense sunlight, the land’s blues, greens, golds all around so crisp and saturated that mere seeing nourishes something akin to spiritual deepening. I’ve been tasked with snatching the little brightness I can out of the jaws of gloom for several months now, but this afternoon’s flood of pure light makes halting the hike just after the one-hour point a little tragic.
“We can’t go a little further?” the son echoes my unspoken longing.
A far-off glimpse of Schooner Bay teases. I’d love to blink and be the old me just one more day.
“Not if we want to drive to Mt. Vision’s summit,” the husband says, “while conditions are clear for epic views.”
I lead us toward the parking spot, convincing myself to be consoled. At the wooden bridge I pause to gaze at a blue heron in the shallows of Home Bay. This spot pinpoints where tectonic land, the fresh water of Home Ranch Creek, and the marine salinity of Drake’s Bay interface, a waypost that spans different realms.
Like me. Disabled and abled. Stricken and emboldened. I’m hanging on. Suspended on a verge.
Mindela Ruby is an educator, writing consultant, and forest bather. Her prose and poetry appear in Santa Monica Review, Kairos Literary Magazine, The Writing Disorder, Coachella Review, Rivet, and other journals as well as the anthology Unmasked. Her short works have been Pushcart and Sundress Best of the Net nominated. A California Arts Council member, she completed a doctoral degree at University of California. She is currently writing a medical memoir.
Header photo of shipwreck near Point Reyes by 12019, courtesy Pixabay.
